Ze (M/13) came for eye examination, with complaints of blurry far vision with existing glasses of 3-4years. His glasses are worn very low, he is seeing through the very top part of lens and there are many scratches on the lenses.
Vision with existing glasses
R: -4.50/-1.25×180 (6/9-, 7.5-)
L: -5.75/-1.25×170 (6/15-, 6/12-)
Examination shows:
R: -5.25/-1.25×180 (6/6) (+1.00 blur lens test 6/9-) N5@40cm [R: right dominant eye]
L: -7.00/-1.50×30 (6/7.5+) PH 6/7.5+ N5 blur@40cm (Retinoscopy shows reflex at meridian 30 & 90 apart)
Add: +1.50
When asked whether or not Ze was told about having amblyopia/lazy eye, father said yes with no history of patching
Other assessments show:
Examination of 3D Vision (Random Dot 3S)
100″ (with L: -7.00/-1.50×30, R same)
12.5″ (with L: -7.50/-1.50×30, R same)
(normal value: 12.5″)
Examination of Eye Alignment/Vergence (Cover Test)
NMD @ Distance
NMD @ Near
(normal value: orthophoria/NMD-No Movement Detected or small XP, fast recovery)
EP = Esophoria is misalignment of the eye, eye is deviated inwards
XP = Exophoria is misalignment of the eye, eye is deviated outwards
Examination of Eye Alignment/Posture (Howell Card) by 6^ Base Down on Right eye
Distance: 0 – 1 – 3 EP (yellow part), slightly over 1 but not reaching 3
Near: 0 – 2 XP (blue part)
+1.00 Near: 2 – 4 XP (blue part), no blink: 0 – 2 XP (blue part)
(normal value: 0-1 EP or 0-3 XP @Distance and 0-6 XP @Near)
EP = Esophoria is misalignment of the eye, eye is deviated inwards
XP = Exophoria is misalignment of the eye, eye is deviated outwards
NRA (Accommodation analysis – ability to relax accommodation) by plus lens
+2.75
(normal value: +1.50 to +2.50)
PRA (Accommodation analysis – ability to stimulate accommodation) by minus lens
-1.25
(normal value: -1.37 to -3.37)
MEM (Accommodation lag – to measure accommodation response seeing near target)
R: +1.25
L: +1.25
(normal value: +0.25 to +0.75)
Facility (Accommodation facility – ability to change focus: far to near or near to far) by Flipper +/- 2.00
RE: 11 cycle per minit(cpm), difficult with minus lens (2nd lens)
R: 8 cycle per minit(cpm), difficult with minus lens(2nd lens)
L: 9 cycle per minit(cpm), difficult with minus lens(2nd lens)
(normal value: 1 cycle = 2 words read
Monocular or R/L: 6cpm to 16cpm
Binocular or BE-both eyes: 4cpm to 14cpm)
Examination of Fusional Reserves (Convergent/Divergent reserve stamina) by Prism Bar
Distance, Base-In/Divergent, NFV: 8/6
Distance, Base-Out/Convergent, PFV: 6/4
(normal value: Break/Recovery)
Near, PFV: 10-28/7-21
Near, NFV: 7-19/5-15
Distance, PFV: 4-18/5-9
Distance, NFV: 4-10/2-6
[Scheiman]
AA (Amplitude Accommodation/Focusing – eye stamina/ability of eye to focus & sustain seeing near clearly) by RAF rule
R: 10 YO, 10 YO, 10 YO
L: 10 YO, 10 YO, 10 YO
(normal value: AA goes according to age; YO=years old)
NPC (Convergence – ability of eye to maintain a single clear near image) by RAF rule
TTN, TTN, 6/8cm
(normal value: Break/Recovery in less than 10cm or to the nose, TTN)
Modified power
R: -5.00/-1.25×180
L: -6.50/-1.50×10
L Axis at 30, he reported seeing shadow
Ze has not had any eye check for the past 3-4years.. it is no good for children to go without eye examination for so many years.. on top of wearing compromised condition of lenses. They are growing, so do their eyes. As much as children need care & attention during their growing ups, the same goes to their young eyes. His left vision is not as strong, it may be due to seeing blurry for many years or the reduced vision is due to amblyopia/lazy eye. We will update his prescription to see if it picks up back again.
We need to wear optimum power, and undercorrection/wearing under-corrected power will actually make it worse.. thus getting the right prescription is important. Wear the power needed by our eyes, and let eyes do what they do best naturally, without burdening them with unnecessary chores. We absolutely can relate to what our eyes are feeling kannn.. just that they cannot tell
In the spirit of new year, let us all care for our eyes more by taking charge in scheduling an eye examination with your nearby optometrist. Should you have any queries, ask us! Optometrists are here for you!❤️